Health intelligence tools to aid VFM decisions. Professor Brian Ferguson Director for Knowledge & Intelligence (England)

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1 Health intelligence tools to aid VFM decisions Professor Brian Ferguson Director for Knowledge & Intelligence (England)

2 Content Spend and Outcome Tool (SPOT) Commissioning for Value work Return on Investment work

3 Value for Money Achieving better outcomes for the same level of resource Achieving the same outcomes with less resource A commissioning decision that achieved either of those things could be deemed to be a cost-effective decision or a decision that would lead to improved efficiency or better value for money

4 Spend & Outcome Tool (SPOT) Has been produced for several years now for the NHS (previously at PCT, now CCG, level) Essential starting point to know where to look further at areas of (e.g.) high spend / poor outcome Could we develop a similar tool for local government? We all know that transport, education and housing contribute to health and wellbeing can we start to look at those using a common framework? And look at the NHS-facing information alongside the local government information single conversation within Health & Wellbeing Boards

5 Spend & Outcome Tool (SPOT) for Local Government

6 Background The Spend and Outcome Tool (SPOT) gives local authorities in England an overview of spend and outcomes across key areas of business including public health and its sub-programmes The tool helps local areas to understand the overall relationship between spend and outcomes, by identifying areas of significant variance which are likely to require more in-depth analysis A number of different benchmarking groups are used to provide a range of peer comparisons The tool is provided in two forms. There is a PDF briefing for each local authority that contains the main outputs from the tool. This is a good place to start, before accessing the interactive spreadsheet that allows you to explore all organisations data in detail. 10-minute video taking users through main outputs of the tool

7 Background SPOT includes a large number of measures of spend and outcome from several different frameworks Spend data has been gathered from the Department of Communities and Local Government (DCLG) for top-tier local authorities To adjust for non-optimal distributions of the underlying data, values are modified through a transformation and z-scoring process.

8 Home Screen On the left, there is a vertical menu which contains your main navigation controls. At the top is a dropdown menu that contains a list of available organisations. Future versions will have the ability to change the time period to switch between Local Authority and CCG geographies.

9 Programme Quadrant Chart Shows how all programme budgets in your chosen organisation perform against the respective national averages, using modified z- scores plotted on axes. Spend plotted on the horizontal, outcome on the vertical. Can be viewed with weighted analysis (multiple outcome measures) or unweighted (single relevant outcome measures).

10 Sub-programme Quadrant Chart SPOT can also display quadrant charts for the contributory sub-programmes. In this example, subprogrammes in Public Health are displayed. From here, you can assess how your chosen programme s constituent parts perform against national comparators using the same method.

11 Spine Charts SPOT provides dynamic spine charts for both high-level programme budgets and Public Health s specific programme budget. These spines cover expenditure and associated outcomes. In these spine charts, the diamond represents the LA value, the black whisker represents range of scores nationally and the green bar represents the range of scores within the geographical region.

12 Boxplots The boxplots are nonparametric displays of the actual (raw) data behind both outcome and spend. The chosen organisation is denoted by the red diamond. Boxplots are provided for a number of peer comparator sets, suggesting areas to look at when exploring variation. On the spend boxplot, subprogramme expenditure can also be displayed.

13 Customised Detail Quadrants Users can drill down into specific programmes and subprogrammes, and create quadrant analyses on-the-fly by assigning relevant outcomes. In this example, Public Health s expenditure on wider tobacco control is being compared against maternal smoking prevalence, with its ONS cluster comparators highlighted.

14 Other Features For your convenience, SPOT will also output a list of all measures both spend and outcomes where it considers the chosen organisation as an outlier, or where there is insufficient data to make that judgement All outputs can be customised and are exportable as PDFs Full access to raw and processed data for end-user analysis Latest: Public Health spine chart has been updated to incorporate all the PHOF measures that local authorities might choose as options for the Health Premium

15 Availability SPOT is available online as both an interactive Excel tool and organisationlevel PDF briefings The PDF profiles are a good place to start your exploration of the SPOT tool. There is also a video introduction that will assist and guide you SPOT resources can be found at: It has been tested on Excel in both Windows 7 and Windows 8 environments. It will not run on Mac. Linux installations running Excel under WINE cannot be guaranteed to run correctly.

16 Help needed We piloted with NICE s Local Government Reference Group and a range of individuals and partners Initial feedback very good Data will improve with use We want to improve the outcome measures in the non-public health programmes have we got the right indicators and can we add others? All feedback welcome to: brian.ferguson@phe.gov.uk or sue.baughan@phe.gov.uk

17 Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire 17

18 Commissioning for Value packs A partnership programme of work Insight packs produced in October 2013 for every CCG Look at spend, drivers of spend and quality and quality for the top 10 (by value) programme budget categories Highlight opportunities for primary and secondary preventative measures Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire 18

19 Focus packs for cardiovascular disease Focus packs for cardiovascular available from National Cardiovascular Intelligence Network (NCVIN): CCG level packs which show opportunities for improving quality and efficiency along the CVD pathway Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire 19

20 Commissioning for Value coming soon Following on from the Insight packs (October 2013) each CCG will receive a pathway on a page for every programme which offered an opportunity for improvement October/November 2014 Complex patient pack November/December 2014: Top 2% of admissions Focus on the patient not the condition Complex patients with multiple admissions for multiple conditions Focus also on mental health and children s pathways Compendium atlas of variation March 2015 Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire 20

21 NHS Any Town CCG

22 Return on Investment (ROI) work Jointly with NICE and other partners Focusing on NICE s initial ROI tools in tobacco control, alcohol and physical activity Developing training and the concept of super users in PHE s distributed Knowledge & Intelligence Teams (KITs) - piloted in Northern and Yorkshire - currently creating a network of super-users across the KITs Plan to commission a short-term piece of work aimed at summarising ROI measures in selected priority areas (supporting PHE s Big Ambitions) Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire

23 And finally. (published March 2014) Produced by PHE Knowledge & Intelligence Team Northern and Yorkshire

24 Thank you for your attention